| 1. |
- Triepels, Ron J. M. A., et al.
(författare)
-
Development of machine learning models to predict posterior capsule rupture based on the EUREQUO registry
- 2023
-
Ingår i: Acta Ophthalmologica. - : John Wiley & Sons. - 1755-375X .- 1755-3768. ; 101:6, s. 644-650
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate the performance of different probabilistic classifiers to predict posterior capsule rupture (PCR) prior to cataract surgery. Methods: Three probabilistic classifiers were constructed to estimate the probability of PCR: a Bayesian network (BN), logistic regression (LR) model, and multi-layer perceptron (MLP) network. The classifiers were trained on a sample of 2 853 376 surgeries reported to the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO) between 2008 and 2018. The performance of the classifiers was evaluated based on the area under the precision-recall curve (AUPRC) and compared to existing scoring models in the literature. Furthermore, direct risk factors for PCR were identified by analysing the independence structure of the BN. Results: The MLP network predicted PCR overall the best (AUPRC 13.1 ± 0.41%), followed by the BN (AUPRC 8.05 ± 0.39%) and the LR model (AUPRC 7.31 ± 0.15%). Direct risk factors for PCR include preoperative best-corrected visual acuity (BCVA), year of surgery, operation type, anaesthesia, target refraction, other ocular comorbidities, white cataract, and corneal opacities. Conclusions: Our results suggest that the MLP network performs better than existing scoring models in the literature, despite a relatively low precision at high recall. Consequently, implementing the MLP network in clinical practice can potentially decrease the PCR rate.
|
|
| 2. |
- Dunker, Suryan L., et al.
(författare)
-
Outcomes of corneal transplantation in Europe : report by the European Cornea and Cell Transplantation Registry
- 2021
-
Ingår i: Journal of Cataract and Refractive Surgery. - : Ovid Technologies (Wolters Kluwer Health). - 1873-4502 .- 0886-3350. ; 47:6, s. 780-785
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To analyze real-world graft survival and visual acuity outcomes of corneal transplantation in Europe. SETTING: Corneal clinics in 10 European Union member states, the United Kingdom, and Switzerland. DESIGN: Multinational registry study. METHODS: All corneal transplant procedures registered in the European Cornea and Cell Transplantation Registry (ECCTR) were identified. Graft survival of primary corneal transplants were analyzed using Kaplan-Meier survival curves with log-rank test and Cox regression. Corrected distance visual acuities (CDVAs) are reported at baseline and 2 years postoperatively using the Lundström distribution matrix. RESULTS: A total of 12 913 corneal transplants were identified. Overall, 32-year graft survival of corneal transplants was high (89%) but differed between indications, ranging from 98% in keratoconus and 80% for trauma. Overall, CDVA improved postoperatively, but the risk for losing vision ranged from 7% (baseline vision ≤0.1 Snellen) to 58% (baseline vision ≥1.0 Snellen). CONCLUSIONS: This report provides a comprehensive overview of graft survival and visual outcomes of corneal transplantation in Europe. In addition, it provides real-world estimates of outcomes for a variety of indications and surgical techniques to support benchmarking and demonstrates the relationship between baseline and postoperative vision.
|
|
| 3. |
- Dunker, Suryan L., et al.
(författare)
-
Practice patterns of corneal transplantation in Europe : first report by the European Cornea and Cell Transplantation Registry
- 2021
-
Ingår i: Journal of Cataract and Refractive Surgery. - : Ovid Technologies (Wolters Kluwer Health). - 1873-4502 .- 0886-3350. ; 47:7, s. 865-869
-
Forskningsöversikt (refereegranskat)abstract
- PURPOSE: To report practice patterns of corneal transplantation in Europe. SETTING: Corneal clinics in 10 European member states (MS), the United Kingdom, and Switzerland. DESIGN: Multinational registry study. METHODS: Corneal transplant procedures registered in the European Cornea and Cell Transplantation Registry were identified. Preoperative donor and recipient characteristics, indication and reason for transplantation, and surgical techniques were analyzed. RESULTS: A total of 12 913 corneal transplants were identified from 10 European Union MS, the United Kingdom, and Switzerland. Most countries were self-sufficient with regard to donor tissue. Fuchs endothelial corneal dystrophy was the most common indication (41%, n = 5325), followed by regraft (16%, n = 2108), pseudophakic bullous keratopathy (12%, n = 1594), and keratoconus (12%, n = 1506). Descemet stripping automated endothelial keratoplasty (DSAEK, 46%, n = 5918) was the most commonly performed technique, followed by penetrating keratoplasty (30%, n = 3886) and Descemet membrane endothelial keratoplasty (9%, n = 1838). Vision improvement was the main reason for corneal transplantation (90%, n = 11 591). Surgical technique and reason for transplantation differed between indications. CONCLUSIONS: This report provides the most comprehensive overview of corneal transplantation practice patterns in Europe to date. Fuchs endothelial dystrophy is the most common indication, vision improvement the leading reason, and DSAEK the predominant technique for corneal transplantation.
|
|
| 4. |
- Segers, Maartje H. M., et al.
(författare)
-
Anesthesia techniques and the risk of complications as reflected in the European registry of quality outcomes for cataract and refractive surgery
- 2022
-
Ingår i: Journal of cataract and refractive surgery. - : Wolters Kluwer. - 0886-3350 .- 1873-4502. ; 48:12, s. 1403-1407
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To determine the trends in anesthesia techniques for cataract surgery over the past decade and their relationship to surgical complications.SETTING: Clinics affiliated with the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO).DESIGN: Retrospective cross-sectional register-based study.METHODS: Variables include patient demographics, visual acuity, ocular comorbidities, surgery characteristics, intraoperative complications, and postoperative complications for the study period from January 2008, to December 2018. The anesthesia methods registered in the EUREQUO and included in the study are topical, combined topical and intracameral, sub-Tenon, regional, and general anesthesia. Multivariate logistic regression models for each complication were constructed to estimate the adjusted odds ratio (OR) and 95% CIs.RESULTS: Complete data were available of 1 354 036 cataract surgeries. Topical anesthesia increased significantly over time (from 30% to 76%, P < .001). Sub-Tenon and regional anesthesia decreased (from 27% and 38% to 16% and 6%, respectively, P < .001), and general and combined topical and intracameral anesthesia remained stable (around 2%). Sub-Tenon (OR, 0.80; 95% CI, 0.71-0.91, P < .001), regional (0.74; 95% CI, 0.71-0.78, P < .001), general (0.53; 95% CI, 0.50-0.56, P < .001), and intracameral anesthesia (0.76; 95% CI, 0.64-0.90, P = .001) carried a significantly decreased risk of posterior capsule rupture (PCR), with and without dropped nucleus, compared with topical anesthesia. The risk of endophthalmitis was significantly lower with regional anesthesia compared with topical anesthesia (OR, 0.60; 95% CI, 0.44-0.82, P = .001).CONCLUSIONS: The use of topical anesthesia for cataract surgery increased over time. Topical anesthesia is associated with an increased risk of PCR with and without dropped nucleus, and endophthalmitis.
|
|
| 5. |
- Segers, Maartje H M, et al.
(författare)
-
Outcomes of cataract surgery complicated by posterior capsule rupture in the European Registry of Quality Outcomes for Cataract and Refractive Surgery
- 2022
-
Ingår i: Journal of cataract and refractive surgery. - : Wolters Kluwer. - 0886-3350 .- 1873-4502. ; 48:8, s. 942-946
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To analyze the outcomes of cataract surgery complicated by posterior capsule rupture (PCR).SETTING: European clinics affiliated to the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO).DESIGN: Retrospective cross-sectional register-based study.METHODS: Data were retrieved from the EUREQUO between January 1, 2008, and December 31, 2018. The database consists of data on demographics, intraoperative complications such as PCR, type of intraocular lens (IOL) material, postoperative refraction, corrected distance visual acuity (CDVA), and postoperative complications.RESULTS: 1 371 743 cataract extractions with complete postoperative data were reported in the EUREQUO. In 12 196 cases (0.9%), PCR was reported. After PCR, patients were more likely to receive a poly(methyl methacrylate) IOL (5.2% vs 0.4%, respectively) or no IOL (1.1% vs 0.02%, respectively) compared with patients without PCR. The refractive and visual outcomes in patients with PCR were significantly worse than in those without PCR (mean CDVA 0.13 ± 0.21 vs 0.05 ± 0.16 logMAR, P < .001; mean absolute biometry prediction error 1.15 ± 1.60 diopters [D] vs 0.41 ± 0.45 D, P < .001). A multivariate linear regression analysis, adjusting for potential explanatory variables, confirmed a statistically significant difference (0.04 logMAR, P < .001, and .70 D, P < .001, respectively). Patients with PCR had significantly more postoperative complications (corneal edema 0.88% vs 0.17%, adjusted odds ratio [aOR], 2.80 95% CI, 2.27-3.45, endophthalmitis 0.11% vs 0.02%, aOR, 4.40 95% CI, 2.48-7.81, uncontrolled intraocular pressure 0.55% vs 0.03%, aOR, 14.58 95% CI, 11.16-19.06, P < .001).CONCLUSIONS: Patients with PCR had significantly worse visual and refractive outcomes and more postoperative complications than patients without PCR. However, most of these patients achieved better postoperative visual acuity than that preoperatively.
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
- Segers, Maartje H. M., et al.
(författare)
-
Risk factors for posterior capsule rupture in cataract surgery as reflected in the European Registry of Quality Outcomes for Cataract and Refractive Surgery
- 2022
-
Ingår i: Journal of cataract and refractive surgery. - : Ovid Technologies (Wolters Kluwer Health). - 0886-3350 .- 1873-4502. ; 48:1, s. 51-55
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To analyze the incidence and risk factors for posterior capsule rupture (PCR) in cataract surgery.SETTING: European clinics affiliated with the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO).DESIGN: Retrospective cross-sectional register-based study.METHODS: Data were obtained from the EUREQUO. The database contains data on demographics, comorbidities, and intraoperative complications, including PCR for the study period from January 1, 2008, to December 31, 2018. Univariate and multivariate logistic regression analyses were performed to estimate the (adjusted) odds ratio (OR) and 95% confidence intervals (CIs).RESULTS: We analyzed EUREQUO registry data of 2,853,376 patients, and 31,749 (1.1%) cataract surgeries were complicated by a PCR. Data were available of 2 853 376 patients, and 31 749 (1.1%) cataract surgeries were complicated by a PCR. The PCR rate ranged from 0.60% to 1.65% throughout the years, with a decreasing trend (P < .001). The mean age of the PCR cohort was 74.8 ± 10.5 years, and 17 29 (55.5%) patients were female. Risk factors most significantly associated with PCR were corneal opacities (OR 3.21, 95% CI, 3.02-3.41, P < .001), diabetic retinopathy (OR 2.74, 95% CI, 2.59-2.90, P < .001), poor preoperative visual acuity (OR 1.98, 95% CI, 1.88-2.07, P < .001), and white cataract (OR 1.87, 95% CI, 1.72-2.03, P < .001).CONCLUSIONS: Risk factors for PCR were identified based on the EUREQUO, and the incidence of this complication is decreasing over time.
|
|
| 9. |
- Behndig, Anders, et al.
(författare)
-
Endophthalmitis prophylaxis in cataract surgery : Overview of current practice patterns in 9 European countries
- 2013
-
Ingår i: Journal of cataract and refractive surgery. - : Ovid Technologies (Wolters Kluwer Health). - 0886-3350 .- 1873-4502. ; 39:9, s. 1421-1431
-
Forskningsöversikt (refereegranskat)abstract
- Data on practice patterns for prophylaxis against infectious postoperative endophthalmitis (IPOE) during cataract surgery in 9 European countries were searched in national registers and reviews of published surveys. Summary reports assessed each nation's IPOE rates, nonantibiotic prophylactic routines, topical and intracameral antibiotic use, and coherence to the European Society of Cataract & Refractive Surgeons (ESCRS) 2007 guidelines. Although the reliability and completeness of available data vary between countries, the results show that IPOE rates differ significantly. Asepsis routines with povidone iodine and postoperative topical antibiotics are generally adopted. Use of preoperative and perioperative topical antibiotics as well as intracameral cefuroxime varies widely between and within countries. Five years after publication of the ESCRS guidelines, there is no consensus on intracameral cefuroxime use. Major obstacles include legal barriers or persisting controversy about the scientific rationale for systematic intracameral cefuroxime use in some countries and, until recently, lack of a commercially available preparation.
|
|
| 10. |
- Nuijts, Rudy M. M. A., et al.
(författare)
-
Ocular tolerance in rabbits after intracameral administration of a fixed combination of tropicamide, phenylephrine, and lidovaine with and without rinsing
- 2017
-
Ingår i: Journal of cataract and refractive surgery. - : ELSEVIER SCIENCE INC. - 0886-3350 .- 1873-4502. ; 43:5, s. 673-679
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: To evaluate the safety and tolerability of a single intracameral administration of a combined mydriatic (tropicamide and phenylephrine) and anesthetic (lidocaine) formulation (Mydrane) with or without rinsing. Setting: Iris Pharma, La Gaude, France. Design: Experimental study. Methods: Sixty pigmented rabbits received 100 mu L or 200 mu L of the combination product or a placebo (sodium chloride 0.9%) by intracameral injection. For the combination product, separate groups were included with and without rinsing after administration. From day 1 day to day 7, assessments included general clinical and ocular observations, pupil diameter measurements, corneal assessments, confocal microscopy, and electroretinography (ERG). Necropsy examinations were performed at study completion at day 8. Results: Rapid mydriasis, stable 24 minutes after injection and returning to baseline levels by day 1, was induced in all groups that received the combination mydriatic and anesthetic drug. Rinsing had no effect. The combination product induced no adverse effects on the anterior or posterior segment of the eye (ie, no increased corneal thickness and endothelial cell loss, no abnormalities in ERG). Slitlamp examination showed slightly increased anterior chamber inflammation with rinsing in both the study group and placebo group. This observation was not confirmed by aqueous flare examination. No toxic effects of the products were found on histological evaluation. Conclusion: The combination mydriatic and anesthetic drug administered to pigmented rabbits as a single intracameral injection at volumes of 100 mu L and 200 mu L was well tolerated with no ocular adverse effects and no effect on the corneal endothelium.
|
|
